How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience

• DOI: 10.1186/s12888-018-1708-9
• Publication Date: 2018-06-14T22:08:20Z
• Authors: Louise Thomson; Marcus Barker; Catherine Kaylor-...; Anne Garland; Rajini Ramana; Richard Morriss; Emily Hammond; Gail Hopkins; Sandra Simpson
• Keywords: Thematic Analysis; Collaborative Care

A specialist depression service (SDS) offering collaborative pharmacological and cognitive behaviour therapy treatment for persistent depressive disorder showed effectiveness against symptoms versus usual community based multidisciplinary care in a randomised controlled trial (RCT) mental health services England. However, there is uncertainty concerning how effect such change. The current study aimed to evaluate the factors which may explain greater of SDS compared Treatment as Usual (TAU) by exploring experience RCT participants. Qualitative audiotaped transcribed semi-structured interviews were conducted 12–18 months after baseline with 21 users (12 SDS, 9 TAU arms) drawn from all three sites. Inductive thematic analysis using grounded approach contrasted experiences Four themes emerged relation user experience: 1. Specific components SDS: included sub-themes management medication change, explaining developing strategies, setting realistic expectations, person-centred holistic approach; 2. Individual qualities clinicians; 3. Collaborative team context communication between healthcare professionals, continuity members; 4. Accessibility flexibility locations, frequent consultation reinforcement, gradual pace treatment, challenges returning care. uncovered important mechanisms contextual that different TAU, technical expertise personal clinicians, teamwork, care, accessibility managing transitions. other share many features SDS. "Trial Clinical Cost Effectiveness Specialist Expert Mood Disorder Team Refractory Unipolar Depressive Disorder" was registered www.ClinicalTrials.gov ( NCT01047124 ) on 12–01-2010 ISRCTN registry www.isrctn.com ISRCTN10963342 25–11-2015 (retrospectively registered).